3. Write it down and close the loop

The record

Indication (spreading cellulitis, not “toothache”), examination findings, what local treatment you provided or why you could not, drug, dose, duration, allergy check, advice given (including sepsis red flags), and the review plan. If you issue a private prescription, say so.

Review

If they should be better in 48–72 hours and are not, they need to be seen — not given a second random antibiotic over the phone. Failure is often undrained infection, wrong diagnosis (including sepsis), or the wrong drug for the organism.

Practice audit

Look at your own prescribing: how many courses after examinations that were pulpitis only? Share anonymised themes in a meeting. Change the emergency protocol if reception still promises a pad.

Series close

Module 1: when drugs help. Module 2: choose, explain, record. Together they are 2 hours of verifiable CPD. Use current national tables on the day you prescribe.

Always follow the BNF, current UK dental antimicrobial guidance, and escalate spreading or septic patients — stewardship is not delay of emergency care.